Model Studies in Orthopaedic Biomechanics

人体肌肉骨骼系统疾病影响到大多数人口，是人们在积极工作期间遭受痛苦和残疾的主要原因，也是缺勤和不断增加的医疗费用方面引起社会关注的主要问题。尽管许多这些疾病的病因（如腰痛、骨关节炎、骨折、关节不稳定、损伤、畸形）往往是一个不确定的问题，但有充分的证据支持机械因素的致病作用。确定机械因素在观察到的损伤、畸形和退化过程中的作用，不仅有利于日益增长的生物医学工业，而且有利于社会的广大阶层，因为它可以减轻所涉及的风险、提高生活质量、提高生产力和降低保健费用。本提案提出了现实和复杂的有限元模型研究多余的人体躯干和下肢（膝关节）神经-肌肉-骨骼系统，椎间盘，半月板，关节软骨和韧带在完整，受伤，退化和重建的条件。这些生物力学研究涉及三维耦合非线性主被动稳定性、运输、弹性静力学/动力学和各种机械载荷、肌肉补充模式和姿势/运动学/边界条件下的多相分析。我们自己内部开发的有限元程序以及可用的软件、数据集和模型将用于完成拟议的研究。我们提出的硅生物力学模型研究结合体内和体外测量（由我们的团队、我们的合作者进行或取自文献）旨在：(1)显著提高我们对人体躯干、膝关节及其组成部分在各种活动中的功能生物力学和结构稳定性的理解；(2)识别损伤、失效、故障和退行性过程中的生物力学风险因素；（三）制定、审查和提出减轻伤害的方法、技术和标准，提高职业、体育和娱乐活动的安全，加快重返工作岗位；(4)研究和改进运动疗法、提高运动成绩和康复管理方案；最后(5)分析和改进被动-主动辅助/矫正装置（外骨骼、足部磨损、支架）、结构体和假肢替代系统的设计。拟议的研究涵盖了骨科和运动生物力学中广泛的新颖和复杂的应用，将培养高素质的工程师和研究人员，以有效应对我们社会和生物医学行业面临的当前和未来的挑战（例如，老龄化，肥胖，更积极的生活方式，预防/治疗措施，康复，运动损伤，旷工，重返工作岗位，医疗保健成本）。

Disorders in human musculoskeletal systems affect the majority of the population and are both a leading cause of sufferance and disability in people during their active working years and a major concern for the society in terms of absenteeism and growing health care costs. Although the etiology of many of these disorders (e.g., low-back pain, osteoarthritis, fractures, joint instabilities, injuries, deformities) is often a matter of uncertainty, there is ample evidence supporting the causative role of mechanical factors. Identification of the role of mechanical factors in observed injuries, deformities and degenerative processes benefits not only the growing biomedical industry but also broad segments of the society by mitigating risks involved, improving quality of life, augmenting productivity and reducing health care costs. This proposal presents realistic and complex finite element model studies of the redundant human trunk and lower extremity (knee joint) neuro-musculoskeletal systems, intervertebral discs, menisci, articular cartilage and ligaments in intact, injured, degenerate and reconstructed conditions. These biomechanical investigations involve 3D coupled nonlinear active-passive stability, transport, elastostatic/dynamics and multi-phasic analyses under various mechanical loading, muscle recruitment patterns and postural/kinematics/boundary conditions. Our own in-house developed finite element programs as well as available software, datasets and models will be used to complete the proposed studies. The proposed in silico biomechanical model studies in combination with in vivo and in vitro measurements (carried out by our group, our collaborators or taken from the literature) are intended to : (1) markedly advance our understanding of the functional biomechanics and structural stability of the human trunk, knee joint and their constituent components in various activities; (2) identify biomechanical risk factors in injuries, failures, malfunctions and degenerative processes; (3) develop, examine and propose methods, techniques and standards to mitigate injuries, improve safety in occupational, sports and recreational activities and expedite return to work; (4) investigate and improve exercise therapies, performance enhancement and rehabilitation management programs; and finally (5) analyze and improve designs of passive-active assistive/corrective devices (exoskeletons, foot wears, braces), constructs and prosthetic replacement systems. The proposed investigations, while covering a wide range of novel and complex applications in orthopaedics and sports biomechanics, will train highly qualified engineers and researchers that are much needed to effectively respond to the current and future challenges (e.g., ageing, obesity, more active lifestyle, prevention/ treatment measures, rehabilitation, sports injuries, absenteeism, return to and stay at work, health-care cost) facing our society and the biomedical industry.